Healthcare or Wealthcare? Oh, and Cruz's plan.....

It has been a few months since I blogged - you know, life. But the healthcare debate raging in the country and Congress is an issue close to my heart. Since I was old enough to understand insurance and politics I have believed in "socialized" medicine and single payer. I even wrote my high school research paper on it - in 1989. Since that time, my family benefited from the Medicaid expansion know as CHIP - Children's Health Insurance Program - from 2000 to 2004. It made all the difference for my family by providing my kids with the well check ups and medical and dental care my ex-husband's insurance didn't provide.(It was catastrophic only coverage.) Now you know my bias. My biggest issue with the Senate Plan (Better Care Reconciliation Act, BCRA) and the House Plan (Affordable Health Care Act, AHCA) is that they rewind us back to health insurance of the 20th century. Let's think about how much has changed since 1975, 1985: cell phones, cars, globalization, job markets, education costs, housing costs, you get the picture. So why are we going backwards on healthcare? I get it - the ACA has problems. (I would argue that is due to Republicans refusing to care about their constituents and Republican led states refusing the Medicaid expansion.) However, it at least acknowledged realities of the 21st century. Insurance Portability: How many times will people change jobs? A Google Search of "on average how many times does a person change jobs in their lifetime" will show you numbers from 4 in your first 12 years of career employment to 10-12 in a lifetime, from multiple types of sources. Basically, the 21st job market means change. In addition, the demand economy (Airbnb, Lyft, Uber) means that many people hold a series of part time gigs to cobble together full time income. The problem with the BCRA and AHCA is that they assume you have insurance through your job and yet those plans don't acknowledge the new economy at all. A Medicaid/Medicare for all plan would allow healthy people to buy into the nationalized health plan and have consistent coverage. This means healthy workers. It also means that small start-ups, you know the entrepreneurs that American individualism idolizes,would be able to start businesses without the burden of healthcare. A healthy labor force is a productive labor force. In addition, this supports innovation and small businesses. Does it mean higher taxes? For the wealthiest and corporations, yes. But there are ways to massage that. Large companies with generous health plans can get a bit of a tax break. More generous 504 plans. And maybe, just maybe, a value added tax. Cost of living: The cost of renting or buying a place to live has skyrocketed. And that doesn't include car prices, cell phones (a necessity regardless of what Jason Chaffetz says), or student loan debt. The tendency of kids to move back in with their parents is why the ACA extended coverage to children to the age of 26. In addition, automation and the internet are putting some job fields at risk. See JC Penney, or coal mining. If there is a penalty for going without health insurance then one has to use COBRA except that is very expensive. Or if you are paying 1/3 of you income in student loan payments, you can't really afford health insurance. It makes sense to keep these workers healthy and keep money in their pockets. Negotiating power: One of the biggest issues with the cost of healthcare is the fact that their are different costs for different states, even cities, even insurers. That is ridiculous. There is no transparency in the health industry. If there is a Medicaid for all plan, then the government will have the power to negotiate prices. Will that have a dampening on medical innovation? Not if we encourage researchers and university hospitals to be on the cutting edge. I am sure there is a way to massage this so as not to weaken the medical research field. As of now, the profit motive means there is more attention paid to impotency than to birth control. This might be a way to direct research away from profits. At the very least, make costs transparent. Plus, single payer options have fewer administrative costs so that will help in negotiations as well. And it might prevent the snafu we had with opiods, where companies targeted doctors directly. For more on single payer, read this New York Times article: On to Ted Cruz's plan. His plan would create a secondary ACA compliant pool for the sickest or riskiest people. Let's remember that the Republicans were worried about Death Panels. What better way to identify sick people than to put them all on the same health plan! And, it would make the market unstable because of the segmentation. It is bad policy and bad economics. It is tea with arsenic in it, make no mistake. It is political wrangling that is just as heartless as before. It would price the middle class out of the market so essentially you would have a worse system of healthcare for the very rich and the very poor but nothing for the middle. It is just lame. And stupid. For more, read this New York Times article on his plan: https://www.nytimes.com/2017/07/05/upshot/ted-cruz-has-an-idea-for-how-to-cover-high-risk-patients.html?em_pos=small&emc=edit_up_20170707&nl=upshot&nl_art=4&nlid=71241221&ref=headline&te=1 The country has been talking about healthcare for 70 years. It is about time we just do something that takes care of all American.